Could COVID-19 get as bad as the 1918 Spanish flu? Fauci, others see similarities

As coronavirus cases surge across the nation in spikes unseen since the pandemic began, infectious disease experts point to the lessons unlearned from a similar outbreak over a century ago.

The 1918 influenza pandemic, also known as the Spanish flu, infected an estimated 500 million people worldwide and killed at least 50 million, with about 675,000 deaths occurring in the U.S., the Centers for Disease Control and Prevention says.

About nine months into the coronavirus pandemic, more than 53 million people have contracted COVID-19 and nearly 1.3 million people have died as of Nov. 13.

The United States — which leads the world in both confirmed coronavirus cases and deaths — reported more than 160,000 new cases of the coronavirus on Thursday, a new record for single-day caseload.

The news came just eight days after the U.S. surpassed 100,000 daily cases for the first time, according to The New York Times.

Dr. Ali Mokdad, a professor of global health at the University of Washington’s Institute for Health Metrics and Evaluation, said numbers can reach Spanish flu levels if current trends continue.

“Our behaviors are not helping us, and we are seeing a rapid increase of cases and deaths, and unfortunately we may surpass what we have seen in 1918 if we continue this behavior,” Mokdad told Seattle’s King 5 News.

Data from Mokdad’s institution estimate that the U.S. could reach about 439,000 COVID-19 deaths by March 1, 2021. If preventive measures such as physical distancing and mask wearing are eased, deaths could amount to about 587,000.

“When I testified before the Congress four months ago I said if we don’t get control of this, then we could reach 100,000 infections per day, and people thought I was being hyperbolic, and now look what’s happening,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases since 1984.

Fauci’s comments were made during a Thursday forum with National Institutes of Health Director Dr. Francis Collins and Dr. Luciana Borio, a member of President-elect Joe Biden’s coronavirus task force.

Fauci also likened COVID-19’s trends to the 1918 Spanish flu.

“We know from historical little anecdotes that actually became studies, that when people took seriously the kind of things that I’m talking about, wearing a mask, physical separation, they did much better in cities that did that than in those that just said ‘the heck with it,’” he said, according to KTVU.

“So history is kind of repeating itself 102 years later,” Fauci added.

Similar anti-virus sentiments were popular a century ago when the influenza outbreak took over everyone’s lives.

About 2,000 members of a so-called Anti-Mask League gathered in San Francisco in 1919 “for a rally denouncing the mask ordinance and proposing ways to defeat it,” Alexander Navarro, assistant director at the University of Michigan’s Center for the History of Medicine, wrote in a July article for The Conversation.

“Noncompliance and outright defiance quickly became a problem,” Navarro wrote. “Many businesses, unwilling to turn away shoppers, wouldn’t bar unmasked customers from their stores. Workers complained that masks were too uncomfortable to wear all day.”

And much like today, some people pleaded for compliance, McClatchy News reported in July. Headlines from Chicago newspapers in 1919 declared, “‘Open-face sneezers to be arrested,” ‘Police raid saloons in war on influenza; Keep church windows open;’ and ‘Nonessential crowds barred in epidemic war.’”